Vega Jose L, Komisaruk Barry R, Stewart Mark
Department of Psychology, Rutgers University-Newark, Newark, NJ, United States.
TeleNeurologia SAS, Medellin, Colombia.
Front Neurol. 2022 Nov 2;13:1021042. doi: 10.3389/fneur.2022.1021042. eCollection 2022.
During physiological stress responses such as vigorous exercise, emotional states of fear and rage, and asphyxia, the nervous system induces a massive release of systemic catecholamines that prepares the body for survival by increasing cardiac output and redirecting blood flow from non-essential organs into the cardiopulmonary circulation. A curious byproduct of this vital response is a sudden, transient, and redistributive leukocytosis provoked mostly by the resultant shear forces exerted by rapid blood flow on marginated leukocytes. Generalized convulsive seizures, too, result in catecholamine surges accompanied by similar leukocytoses, the magnitude of which appears to be rooted in semiological factors such as convulsive duration and intensity. This manuscript reviews the history, kinetics, physiology, and clinical significance of post-convulsive leukocyte elevations and discusses their clinical utility, including a proposed role in the scientific investigation of sudden unexpected death in epilepsy (SUDEP).
在生理应激反应期间，如剧烈运动、恐惧和愤怒等情绪状态以及窒息时，神经系统会促使全身儿茶酚胺大量释放，通过增加心输出量以及将血液从非必需器官重新导向心肺循环，使身体做好生存准备。这种重要反应的一个奇特副产品是突然、短暂且具有再分布性的白细胞增多，这主要是由快速血流对边缘白细胞施加的剪切力导致的。全身性惊厥发作也会导致儿茶酚胺激增，并伴有类似的白细胞增多，其程度似乎与惊厥持续时间和强度等症状学因素有关。本文综述了惊厥后白细胞升高的历史、动力学、生理学及临床意义，并讨论了其临床应用，包括在癫痫性猝死（SUDEP）科学研究中拟发挥的作用。
